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J Korean Med Assoc > Volume 50(8); 2007 > Article
Kim: The Management of Arthritis

Abstract

Rheumatoid arthritis (RA) is a chronic inflammatory disease of the joint, for which treatment strategies have remained suboptimal for a long time. The treatment of RA has changed dramatically during the past decade due to the better understanding of its pathogenesis. Especially in early RA, early diagnosis and appropriate treatment is highlighted, with the treatment goal being clinical remission. In order to prevent joint damage and long-term disability, early use of disease-modifying anti-rheumatic drugs (DMARDs) is a key. Aggressive treatment such as combination of DMARDs and glucocorticoids or biological agents can induce a high rate of remission, suppression of joint damage and provide better outcome than DMARD monotherapy in early RA and should be considered in high-risk patients. Timely adjustment of therapy until patients have achieved low levels of disease activity is also crucial. On the other hand, treatment for osteoarthritis has mainly been focused on the alleviation of pain, while the goal of disease modification still remains elusive. Because the long-term use of non-steroidal anti-inflammatory agents poses significant risk of adverse events on the elderly, nonpharmacologic therapy including weight reduction, muscle strengthening, and exercise is recommended first. Recent advances in the understanding of the pathogenesis of osteoarthritis may provide a clue that will ultimately lead to disease modification.

References

1. Bradley JD, Brandt KD, Katz BP, Kalasinski LA, Ryan SI. Comparison of an anti-inflammatory dose of ibuprofen, an analgesic dose of ibuprofen, and acetaminophen in the treatment of patients with osteoarthritis of the knee. N Engl J Med 1991;325:87-91.

2. Brook M. In: Hochberg M, Silman A, Smolen J, Weinblatt M, Weisman M, editor. Nonsteroidal anti-inflammatory drugs. Rheumatology 2003;1:3rd ed. London: Mosby. 377-384.

3. Goekoop-Ruiterman YP, de Vries-Bouwstra JK, Allaart CF, van Zeben D, Kerstens PJ, Hazes JM, Zwinderman AH, Peeters AJ, de Jonge-Bok JM, Mallee C, de Beus WM, de Sonnaville PB, Ewals JA, Breedveld FC, Dijkmans BA. Comparison of treatment strategies in early rheumatoid arthritis: a randomized trial. Ann Intern Med 2007;146:406-415.

4. Clegg DO, Reda DJ, Harris CL, Klein MA, O'Dell JR, Hooper MM, Bradley JD, Bingham CO 3rd, Weisman MH, Jackson CG, Lane NE, Cush JJ, Moreland LW, Schumacher HR Jr, Oddis CV, Wolfe F, Molitor JA, Yocum DE, Schnitzer TJ, Furst DE, Sawitzke AD, Shi H, Brandt KD, Moskowitz RW, Williams HJ. Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis. N Engl J Med 2006;354:795-808.

5. Raynauld JP, Buckland-Wright C, Ward R, Choquette D, Haraoui B, Martel-Pelletier J, Uthman I, Khy V, Tremblay JL, Bertrand C, Pelletier JP. Safety and efficacy of long-term intraarticular steroid injections in osteoarthritis of the knee: a randomized, double-blind, placebo-controlled trial. Arthritis Rheum 2003;48:370-377.



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